Telehealth On The OIG’s Radar

Telehealth is one of the fastest growing markets in health care, and with the ever-increasing availability and growth of technology, telehealth will continue to play a significant role in the future of health care. In an attempt to keep up with the dynamic and rapidly changing telehealth market, federal and state agencies have responded by developing a patchwork of different [...]

By |2018-02-27T08:54:45-07:00December 20, 2017|

CMS Emergency Preparedness Rule Takes Effect Nov. 15

In the wake of Hurricanes Harvey, Irma and Maria, the November 15, 2017 deadline for new Centers for Medicare and Medicaid Services regulations on emergency preparedness seems all the more critical. Hundreds of facilities were devastated by flooding and damage, leaving them without vital patient data and at risk of security breaches and Health Insurance Portability and Accountability Act violations. [...]

By |2017-10-13T10:37:21-07:00October 10, 2017|

Episode 4: Health Law Rundown Podcast Covers Criminal Impacts on Health Care Licensing

BOULDER—Aug. 1, 2017—Episode 4 of the Health Law Rundown, a podcast created by Caplan and Earnest attorney Matt Ullrich, is now available. Episode 4 includes a discussion with Caplan and Earnest attorneys Sheryl K. Bridges and Greg Lindquist about the health care issues and ramifications a practitioner providing Medicare or Medicaid services and licensed under the Colorado Medical Board or [...]

By |2017-11-02T09:31:09-07:00August 1, 2017|

Medicare Fraud Strike Force Sends Strong Message on Fraud and Abuse

Highlighting its continued focus on cracking down on Medicare fraud and abuse practices, the U.S. Department of Justice and the U.S. Department of Health and Human Services announced this month the largest ever health care fraud enforcement action precipitated by the Medicare Fraud Strike Force. As part of this national health care fraud takedown, the government charged 412 defendants with approximately $1.3 billion [...]

By |2017-10-10T13:03:18-07:00July 27, 2017|

New Legislation to Affect Colorado Medical and Dental Providers in August

Many health care professionals struggle with traditional models of patient care because of limitations on reimbursement imposed by insurance companies. When they are forced to rely on insurance companies and federally funded programs such as Medicare and Medicaid to determine coverage and reimbursement rates, these health care professionals are stretched thin. To cover overhead costs, they often schedule as many [...]

By |2017-06-28T13:09:12-07:00June 28, 2017|

Health Care and the 2017 Colorado Legislative Session

Note: Josiah Beamish, J.D., a health law clerk for Caplan and Earnest, was instrumental in compiling this information. The 2017 Colorado Legislative Session resulted in some key pieces of health care legislation, which allowed the legislature to address several long-term needs in the state’s health care system. One of the biggest developments this legislative session is the commitment to supporting [...]

By |2017-06-09T13:55:50-07:00June 6, 2017|

Medicaid and CHIP Beneficiaries Gain Parity Access for Mental Health and Substance Use Services

Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries will receive greater access to mental health and substance use disorder benefits in the future based upon a final rule released on March 29 by the Centers for Medicare & Medicaid Services (CMS). In the final rule, CMS requires Medicaid and CHIP programs to deliver mental health and substance use services equal [...]

By |2016-12-27T11:06:25-07:00April 20, 2016|

Revalidation and Enrollment Begins Sept. 15 for Colorado Medicaid Providers

As required by the Affordable Care Act, all existing Medicare and Medicaid providers, including all Child Health Plan Plus (CHP+) providers, must revalidate by March 31, 2016. In order to meet these requirements and to ensure that all Colorado Medicaid providers are enrolled in its new claims processing and payment system, known as the Colorado interchange, Colorado Medicaid will begin [...]

By |2016-12-27T11:06:35-07:00September 14, 2015|

Medicare Physician Fee Schedules Expired March 31, but Congress, CMS Offer Hope

Medicare providers are acutely aware that March 31, 2015 marked an important date – the date that the current Medicare Physician Fee Schedule expired.  Enacted in 1997, the Medicare Sustainable Growth Rate (SGR) was intended as a method for the Centers for Medicare and Medicaid Services (CMS) to control the Physician Fee Schedule and to begin to reduce Medicare spending.  [...]

By |2016-12-27T11:06:40-07:00April 3, 2015|

Half of Medicare Payments to Shift to Alternative Models by 2019

In news that affects hospital providers, the United States Department of Health and Human Services recently set goals and a timeline for shifting half of Medicare payments by 2019 to alternative models that are based on the quality, not quantity, of care that providers give patients. HHS set the goal of tying 30 percent of traditional Medicare payments to quality [...]

By |2016-12-27T11:06:51-07:00February 2, 2015|